Floppy Flop
Try This
Why Are You Bleeding
Please Stop
Be a Team or Something
100
What are the first non-medication intervention to be done to stop bleeding if uterine atony is the suspected cause?
When atony is suspected, the bladder should be emptied and a bimanual pelvic examination conducted, any intrauterine clots should be removed, and uterine massage should be performed
100
This medication works as a competitive inhibitor of the lysine receptor on plasminogen and has shown it's greatest benefit when used within the first 3 hours of delivery.
TXA
100
This is a life threatening condition in which either a portion of or the entire placenta invades into the myometrium and fails to separate from the uterine wall during the third stage of labor
Placenta accreta; in the presence of placenta previa and a history of cesarean delivery, the obstetrician–gynecologist should have a high clinical suspicion for placenta accreta. The risk was far higher in women with placenta previa with 3%, 11%, 40%, 61%, and 67% of such women with their first through fifth or more cesarean deliveries having a placenta accreta.
100
This amount of bleeding is quite concerning and should trigger preparation for mass transfusion
1500 mL; In women with ongoing bleeding that equates to the blood loss of 1,500 mL or more or in women with abnormal vital signs (tachycardia and hypotension), immediate preparation for transfusion should be made.
100
Who can/has to activate and deactivate MTP?
The Physican; you also have to be present when it's started
200
Which uterotonic medication is an analog of PG-F2a?
Hemabate (Carboprost)
200
One of the largest series in studying this method of PPH management showed a success rate of greater than 80%; however, infertility has been reported in up to 43% of women
UAE: Call or Haiku Cam Richardson (417) 793-6066
200
This is Angela's favorite color
I don't actually know, refer to Angela
200
When a massive transfusion protocol is needed, fixed ratios of packed red blood cells, fresh frozen plasma, and platelets should be used. The recommended initial transfusion ratio for packed red blood cells:fresh frozen plasma:platelets has been in the range of this ratio and is designed to mimic replacement of whole blood.
1:1:1; These recommendations are different from protocols that have previously suggested ratios such as 4:4:1 or 6:4:1 and are related to how a unit of platelets is defined. What is more important than the actual ratio is that there is a specific protocol for multicomponent therapy in place at each institution.
200
Which day time RN has the highest seniority? Which night time RN?
Day Krisiti V; Night- Tracy Kemmerling
300
If treatment with medications don't work, treatment with an intrauterine balloon can be considered if there's persistent lower uterine atony. We often use a Jada. How much fluid goes into the cervical seal and to how many mmHg do we set the suction at? Bonus if you can walk through the whole process of Jada insertion
60 mL-120mL; 80 mmHg
300
The general aim of vascular ligation in the setting of atony is to diminish the pulse pressure of blood flowing to the uterus. A common first approach is bilateral uterine artery ligation which commonly accomplishes this goal of reducing blood flow to the uterus, and is quickly and easily performed. This technique is also known as what kind of suture?
O-Leary
300
Upon bimanual examination, the finding of a firm mass at or below the cervix, coupled with the absence of identification of the uterine corpus on abdominal examination, suggests what?
Uterine inversion
300
Refusal of blood products is common in patients who are Jehovah’s Witnesses. This subset of patients has between a *** to ***-fold higher risk of maternal mortality from obstetric hemorrhage because of refusal of blood products
44-130; Because this population may accept some blood products, a predelivery directive that can be used in the event of a severe postpartum hemorrhage can be discussed with the patient during the prenatal period
300
This is the code to the hemorrhage cart
12345 Enter
400
Adverse effects of this uterotonic medication include: Nausea, vomiting, diarrhea, shivering, transient fever, and headache
Misoprostol
400
What is this suturing technique called and how is it supposed to work? 
B-lynch; to provide uterine compression
400
In the setting of postpartum hemorrhage and a vaginal delivery, accreta should be strongly suspected if the placenta does not detach easily, and there should be no further attempt to manually remove the placenta in the delivery room. What should the patient be counseled on before going back to the OR?
The patient should be counseled about the likely need for hysterectomy and blood transfusion.
400
This is the year the stop sign was installed
1915; The first was allegedly installed in Detroit, MI with a simple black and white design. It was first invented 1914 by Sgt Harold "Harry" Jackson who was a traffic guard at the time.
400
These two nurses are sister-in-laws
Kailey and Kaelyn
500
What is the route, dosage, and frequency of Methylergovine given in the setting of uterine atony?
What about route, dosage and frequency Hemabate?
Methergine: IM 0.2mg every 2-4 hours
Hemabate: IM or Intramyometrial 0.25mg every 15-90 min (8 doses max)
500
This type of suture is what we have available for a B-lynch and is allegedly located in the hemorrhage cart and in our OR in the bottom of the cabinet.
1 Chromic on a large curved needle
500
In the event of uterine inversion, manual replacement with or without uterine relaxants usually is successful with the large majority being successfully replaced in one small series. In the unusual circumstance in which it is not, laparotomy is required. These two procedures have been reported to return the uterine corpus to the abdominal cavity.
The Huntington procedure: Progressive upward traction on the inverted corpus using Babcock or Allis forceps. The Haultain procedure: Involves incising the cervix posteriorly, which allows for digital repositioning of the inverted corpus, with subsequent repair of the incision.
500
Tell me the difference between FFP and cryoprecipitate
500
Can you name all of our attendings in 30 seconds?
17?
Hosp: Tryska, Betcher, Galloway, McMaster, Tuter, Prz
Lakes: Freel, Quinn, Brazda, Cree, Fleese
OGA: Sikkenga, Sando, Spitzley, McCormick, Kirby, Parks